A trapeziectomy is an operation to remove the trapezium bone at the base of the thumb, treating arthritis of the first carpometacarpal (CMC) joint. It is the most common surgical treatment for thumb base arthritis.
An incision is made over the base of the thumb on the back of the hand. The trapezium bone is carefully removed. In some cases, a piece of tendon is used to fill the space and stabilise the thumb (ligament reconstruction tendon interposition). Alternatively, a temporary wire may hold the thumb in position for a few weeks. The operation takes approximately 45–90 minutes.
Surgery is recommended for significant thumb base arthritis causing pain with pinching, gripping, and twisting movements when non-operative treatments have not provided adequate relief.
Thumb splints, pain medication, hand therapy, activity modification, and corticosteroid injections can provide effective relief for many patients.
Standard pre-assessment. Plan for the hand and thumb being in a splint or cast for several weeks. You will need help with daily activities during the initial recovery.
Good pain relief is achieved in the majority of patients. Pinch and grip strength improve gradually over several months. The thumb may appear slightly shorter but this rarely causes functional problems. Full recovery takes six to twelve months.
Pinch strength is reduced initially and takes several months to recover.
Thumb movement may be limited initially. Hand therapy is essential.
Tenderness around the incision is common for several weeks.
Sensory nerves near the incision may be damaged, causing numbness at the base of the thumb.
Uncommon during the procedure.
Wound infection requiring antibiotics.
Chronic pain and stiffness in the hand.
The thumb metacarpal may migrate into the space left by the removed bone, potentially reducing strength.
Usually performed under general anaesthesia or regional arm block. Sometimes combined with local anaesthesia.
A plaster cast or splint is worn for four to six weeks. After cast removal, hand therapy begins to restore movement and strength. Light activities resume at six to eight weeks. Full functional recovery takes six to twelve months. Pinch strength continues to improve for up to a year.
Wound check and X-ray at two weeks. Cast removal and start of hand therapy at four to six weeks. Surgeon review at three months.
Scar tissue fills the gap naturally. If a tendon was used, it provides a cushion. The thumb functions well without the trapezium.
Grip and pinch strength improve gradually over six to twelve months. They may not return to pre-arthritis levels but are usually sufficient for normal activities.
Yes, the unaffected hand can be used normally throughout.